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<meta name="description" content="模块 17：通用刮治器(universal curets)通用刮治器的设计特点和使用。Section1:通用刮治器(Universal Curets)1.通用刮治器的功能A.用来去除小的或中等大小的牙石。①龈上龈下通用。②双端成对，镜像器械。B.是最常用和多功能的牙石去除器械。可以用于前牙和后牙，即可以用于整个口腔。2.设计特点：A.一个圆钝的背部。B.一个圆钝的尖部。C.半圆形的横断面。D.每个">
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        <p><strong>模块 17：通用刮治器(universal curets)</strong><br>通用刮治器的设计特点和使用。<br><strong>Section1:通用刮治器(Universal Curets)</strong><br>1.通用刮治器的功能<br>A.用来去除小的或中等大小的牙石。<br><img src="https://zymblog-1258069789.cos.ap-chengdu.myqcloud.com/blog0110-yxgzjc26/01.png"><br>①龈上龈下通用。<br>②双端成对，镜像器械。<br>B.是最常用和多功能的牙石去除器械。可以用于前牙和后牙，即可以用于整个口腔。<br>2.设计特点：<br>A.一个圆钝的背部。<br>B.一个圆钝的尖部。<br>C.半圆形的横断面。<br>D.每个工作末端有两个切割边缘。<br>E.器械工作端的上面(face)与短柄成90°角，因此，两个切割边缘在同一水平。<br><img src="https://zymblog-1258069789.cos.ap-chengdu.myqcloud.com/blog0110-yxgzjc26/02.png"><br>通用刮治器的选择<br>长短对选择的影响<br><img src="https://zymblog-1258069789.cos.ap-chengdu.myqcloud.com/blog0110-yxgzjc26/03.png"><br>短的短柄，在用于去除正常龈沟和窄的袋的时候是一个很好的选择。<br><img src="https://zymblog-1258069789.cos.ap-chengdu.myqcloud.com/blog0110-yxgzjc26/04.png"><br>长的短柄器械：用于深袋的牙石去除。<br><img src="https://zymblog-1258069789.cos.ap-chengdu.myqcloud.com/blog0110-yxgzjc26/05.png"><br><strong>Section2:牙石去除的概念(Calculus Removal Concepts)</strong><br>去除牙石的一些概念<br>稳定（stabilization）：用示指和拇指在器械柄上施加压力，并使手指支点与牙齿相对接触。<br>贴合（Adaptation）：切割边缘的尖1/3与牙冠或牙根表面相贴合。<br>成角（Angulation）：70-80度角，对于通用刮治器，短柄必须与牙齿表面稍微倾斜以达到正确的角度。<br>为了去除牙石的侧向压力（Lateral Pressure for Calculus Removal）：在短的，有控制的牙石去除过程中，使用中度的压力与牙齿表面保持对抗，使用一个远离结合上皮软组织基底的用力方向。<br>力的特点（Characteristics）：有力的，有控制的力量，长度较短。<br>用力方向（Stroke Direction）：在前牙和后牙的近远中区域最常用的是垂直用力。后牙颊舌侧用力常为倾斜用力。在后牙线角和前牙颊舌侧中线区域使用水平用力方向。<br>用力数量（Stroke Number）：牙石去除用力应该局限于有牙石存在的区域，使用所需的最少数量的用力次数。<br><img src="https://zymblog-1258069789.cos.ap-chengdu.myqcloud.com/blog0110-yxgzjc26/06.png"><br>牙石去除的动作序列：准备-插入刮治器工作端-评估-放置工作端-咬合（用工作端咬合住牙石）-锁定尖端，打开工作端的上面（即使角度调整到80度左右）-刮治用力-两次用力之间稍微暂停。<br><strong>Section3:技术练习——后牙(Technique Practice——Posterior Teeth)</strong><br>有两种方法辨认通用刮治器的正确的工作端。临床上同时使用短柄<br><img src="https://zymblog-1258069789.cos.ap-chengdu.myqcloud.com/blog0110-yxgzjc26/07.png"><br>当短柄与牙体远中面平行时正确贴合的工作端。工作柄向上并远离牙齿。<br><img src="https://zymblog-1258069789.cos.ap-chengdu.myqcloud.com/blog0110-yxgzjc26/08.png"><br>如果工作端贴合时短柄不与牙体平行，那选择就是错误的。<br>或者使用切割刃的内侧和外侧。<br><img src="https://zymblog-1258069789.cos.ap-chengdu.myqcloud.com/blog0110-yxgzjc26/09.png"><br>拿起器械从正面(face)往下看，靠近器械的一侧是内侧，另一侧为外侧。<br>建立70°-80°的贴合角度<br>在建立正确的工作端与牙面贴合角度时必须留意刮治器上面与短柄的关系。<br><img src="https://zymblog-1258069789.cos.ap-chengdu.myqcloud.com/blog0110-yxgzjc26/10.png"><br>不正确的角度，因为器械工作端上部与短柄成90°角，如果短柄与牙体表面平行，则工作刃与牙体成角就是90°。<br><img src="https://zymblog-1258069789.cos.ap-chengdu.myqcloud.com/blog0110-yxgzjc26/11.png"><br>正确的角度需要将短柄稍微向患牙牙体表面倾斜，这样工作刃就能与牙体成70°-80°角。<br><img src="https://zymblog-1258069789.cos.ap-chengdu.myqcloud.com/blog0110-yxgzjc26/12.png"><br>在后牙应用切割边缘<br>通用刮治器的所有四个切割边缘都可以用于后牙的牙石去除。<br>例如，用于右下后牙区域。<br><img src="https://zymblog-1258069789.cos.ap-chengdu.myqcloud.com/blog0110-yxgzjc26/13.png"><br>每个牙位四个切割刃都会用到。<br><img src="https://zymblog-1258069789.cos.ap-chengdu.myqcloud.com/blog0110-yxgzjc26/14.png"><br>(具体过程略了，反正临床也不用了）<br><strong>Section4:技术改变——短柄的位置(Technique Alert——Lower Shank Position)</strong><br>当操作者手挡住下颌舌侧牙面的视线或者后牙圆的牙冠使得器械很难到达这些牙齿的根面时，工作端贴合牙面就面临挑战。<br>包括不正确的手柄位置，短柄靠向牙面，工作刃尖端贴合等。<br><img src="https://zymblog-1258069789.cos.ap-chengdu.myqcloud.com/blog0110-yxgzjc26/15.png"><br>正确的做法：使用镜像操作，短柄与根面平行，尖端1/3贴合牙面。<br><img src="https://zymblog-1258069789.cos.ap-chengdu.myqcloud.com/blog0110-yxgzjc26/16.png"><br><strong>Section 5:技术练习——前牙(Technique Practice——Anterior Teeth)</strong><br>前牙与后牙不同，一些人喜欢不在前牙区域使用通用刮治器。但其设计有利于进入下颌前牙舌侧牙根面，并且前后牙都使用单独的一个刮治器比较方便。<br>方法一：短柄作为视觉线索<br>正确的选择工作端使得短柄通过牙面。<br><img src="https://zymblog-1258069789.cos.ap-chengdu.myqcloud.com/blog0110-yxgzjc26/17.png"><br>错误的选择：短柄在牙面一侧。<br><img src="https://zymblog-1258069789.cos.ap-chengdu.myqcloud.com/blog0110-yxgzjc26/18.png"><br>方法二：切割刃的内侧/外侧作为视觉线索<br>同后牙的情况。<br>使用的切割边缘：与后牙不一样，每个工作端只有一个切割边缘用于前牙的刮治。①短柄通过牙面。②只有外侧的切割边缘用于刮治。<br><img src="https://zymblog-1258069789.cos.ap-chengdu.myqcloud.com/blog0110-yxgzjc26/19.png"><br><img src="https://zymblog-1258069789.cos.ap-chengdu.myqcloud.com/blog0110-yxgzjc26/20.png"><br>具体步骤略了。<br><strong>Section6:技术改变——水平刮治(Technique Alert——Horizontal Strokes)</strong><br>新手通常在去除①后牙根面接近近中颊侧和远中舌侧线角区域；②前牙根面颊侧和舌侧中线区域的牙石时存在困难。在这些区域刮治使用水平刮治用力很有帮助。<br>就这么刮<br><img src="https://zymblog-1258069789.cos.ap-chengdu.myqcloud.com/blog0110-yxgzjc26/21.png"><br><strong>（总结：通用刮治器，主要特点是工作端和短柄成90°角，一把器械全口通用。后牙区域要使用到四个切割边缘，前牙区域使用两个，即外侧的两个。后牙时短柄与牙面平行，前牙时短柄斜行通过牙面。临床上用得很少，主要还是用特定牙位的刮治器。）</strong></p>
<p>我发文章的三个地方，欢迎大家在朋友圈等地方分享，欢迎点“好看”。谢谢。<br>我的个人博客地址：<a href="https://zwdnet.github.io/">https://zwdnet.github.io</a><br>我的CSDN博客地址：<a target="_blank" rel="noopener" href="https://blog.csdn.net/zwdnet">https://blog.csdn.net/zwdnet</a><br>我的微信个人订阅号：赵瑜敏的口腔医学学习园地</p>
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